Frequently Asked Questions

Hemorrhoids are common and occur in approx. 50% of people during their life with a peak incidence at the age of 45-65 years. They can be caused through an increase in pressure in the lower rectum by the following reasons: straining, sitting for long periods, spinal cord injury, chronic constipation or diarrhea, anal intercourse, family history of hemorrhoids, excessive exercise.

Eating high fiber food, drinking enough fluid, and exercise can all help with preventing the occurrence of hemorrhoids. Avoid straining when sitting on the toilet, and in general, avoid sitting for long periods of time.

The embolization treatment is the best option for you if you suffer from internal hemorrhoids of grade 1, 2 or 3 and treatment despite hygiene and dietary measures, medication or non-surgical minimally invasive methods were not successful. Also, if you did not benefit from or do not desire a surgical treatment, this technique can be the right option for you. Prior to treatment, imaging may be performed to identify if this procedure is suitable for your vascular anatomy.

We may not perform this treatment if you have been diagnosed with a grade 4 internal hemorrhoids and should you require surgery, have had acute hemorrhoidal complications, a history of colorectal surgery or chronic anal fissures. Allergy to the contrast medium may require medication to prevent contrast reaction, but it is not an absolute contraindication.

We typically do not require preoperative imaging of the arteries as our experience with the procedure is so vast that we can perform this without requiring patients to undergo an additional test or expense.

To diagnose PVD, the physician will begin by taking a complete medical history and physical exam. Several tests may be used to diagnose PVD. They are:

• Measuring the pulses in your legs and feet
• Doppler ultrasound
• Ankle-Brachial Index (ABI)
• Pulse Volume Recording (PVR)
• Angiography

Treatment options we offer:

Once angiographic images have been obtained and problem areas identified, some of the methods we utilize to treat those diseased areas are Angioplasty, Thrombectomy, Atherectomy, or Stent placement.

To control PAD, you should stop smoking and walk every day. It is also beneficial to limit the consumption of high-fat and high-sugar foods and to talk with your primary care physician about the management of risk factors such as diabetes, high cholesterol and high blood pressure.

There may be some recovery time needed after certain PAD treatments. For example, patients who undergo angioplasty to open clogged arteries may have various activity restrictions that last a few weeks. Most interventional procedures are performed on an outpatient basis. Before the day of treatment, patients receive detailed pre- and post-procedure instructions to help in their recovery. Our team is available to answer questions that may arise.

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate gland affecting about 50% of men by age 60, and up to 90% of men by age 85. This enlargement can compress the urethra, reducing the flow of urine from the bladder, and sometimes blocking it entirely. The symptoms of BPH include:

• Urinary frequency
• Irregular flow
• Urgency
• Weak stream
• Straining
• Getting up at night to urinate

If left untreated, BPH can lead to permanent bladder damage. When the bladder does not empty completely, the risk of developing urinary tract infections (UTIs) may increase. Other serious problems can also develop over time, including bladder stones, blood in the urine, incontinence, or urinary retention.

You may want to seek BPH treatment if you experience BPH symptoms such as urgent need to urinate, difficulty starting your urine stream, need to push or strain when urinating, dribbling, the sensation that the bladder is not empty after urinating, weak urine flow, increased frequency of urination, frequent nighttime urination, burning or pain during urination.

No, BPH (Benign Prostatic Hyperplasia) is a benign condition and unrelated to prostate cancer; however, it can greatly affect a man’s quality of life. BPH is NOT a type of cancer.

• Pain in the knee joint
• Stiffness (usually related to time of day)
• Swelling of the knee joint
• Difficulty walking up and down stairs
• Difficulty walking on flat surfaces
• Tenderness in areas around the knee

Weight loss / physical therapy

Reduction in weight and Physical Therapy may be associated with improvement in symptoms, however pain may limit one’s ability to do so.

Medications / joint injections

Medications such at Tylenol or Ibuprofen may be effective in reducing symptoms of knee pain and swelling but can also have side effects such as gastritis, liver or kidney damage. Steroid or Lubricant Injections may act temporarily in some patients.

Surgery

Knee Replacement surgery and other variations of joint replacement are commonly performed in patients whom other measures fail.

Genicular Artery Embolization (GAE)

GAE is a minimally invasive procedure to reduce the inflammation and pain in the knee by reducing the blood supply to the lining of the knee that causes pain and tenderness.

GAE is useful to relieve knee pain from OA instead of taking frequent medication or getting injections into the knee. It can also be beneficial in those who are not ready to have a knee replacement surgery. Published clinical studies by our team have demonstrated that GAE can provide pain relief without the risks associated with chronic medication or having to get repeat injections. GAE, however, is not necessarily a substitute for total knee replacement and has not been shown to negatively impact future knee replacement surgery when performed with our technique.

Our Expert Interventional Radiologists have been performing Genicular Artery Embolization (GAE) for more than 10 years and also published the first Clinical Studies, including a Randomized Controlled Study in the United States. We remain committed to evidence based treatment recommendations and the decision for treatment remains individualized based on your symptoms and disease severity.

Our team will work with your insurance company to get authorization for your procedure. In our experience, we are able to get coverage for most patients based on their history and examination.

Call or email us and we will schedule you for a consultation with our Interventional Radiology Team.

The technique we use should not cause any interference with any future knee surgery, including joint replacement surgery. While there are some physicians who are using metal coils, we do NOT use this technique as there is no published clinical data to support that technique or method of treatment with positive outcomes. Our physicians have performed FDA approved clinical studies in this treatment for the longest time in the US.

Typical symptoms are mild and many do not require treatment. Treatment may be necessary if the varicocele is causing discomfort or any of the other problems listed below.

1. Pain

One of the signs of varicoceles is an aching pain when the individual has been standing or sitting for an extended time and pressure builds up in the affected veins. Heavy lifting may make varicocele symptoms worse and, in some cases, can even cause varicoceles to form.

2. Fertility problems

There is an association between varicoceles and infertility or subfertility, but it is difficult to be certain if a varicocele is the cause of fertility problems in any one case. In one study, as many as 40 percent of men who were subfertile were found to have a varicocele. Other signs of varicoceles can be a decreased sperm count; decreased motility, or movement, of sperm; and an increase in the number of deformed sperm. It is not known for sure how varicoceles contribute to these problems, but a common theory is that the condition raises the temperature of the testicles and affects sperm production. Studies have shown that 50-70 percent of men with fertility problems will have a significant improvement in the quality and/or quantity of sperm production after they have undergone varicocele repair.

3. Testicular atrophy

Atrophy, or shrinking, of the testicles is another of the signs of varicoceles. The condition is often diagnosed in adolescent boys during a sports physical exam. When the affected testicle is smaller than the other, treatment is often recommended. The repaired testicle will return to normal size in many cases.

Sometimes a varicocele can be diagnosed during a physical examination. A large varicocele may make the scrotum look lumpy so it resembles “a bag of worms”.

When varicocele symptoms are not clearly present, the abnormal flow of blood can often be detected with a varicocele ultrasound, a noninvasive imaging exam called color flow ultrasound. Varicoceles also may be detected with a venogram – an x-ray in which a special dye is injected into the veins to “highlight” blood vessel abnormalities.

In the United States, varicocele treatment has traditionally involved open varicocele surgery, usually performed by a urologic surgeon, or urologist. In recent years, however, a safe and effective nonsurgical alternative called varicocele embolization is becoming the treatment of choice for many patients and their physicians.

Men with ED who have failed medications and are found to have a vascular cause—confirmed through imaging or specialized testing—may benefit from these procedures.

Studies and real-world data show promising results, with many patients reporting improved erectile rigidity and duration. Individual success depends on overall health, anatomy, and severity of disease.

No. These are minimally invasive treatments done under light sedation. Most men describe little to no discomfort during or after.

Patients usually return to normal activities within 24–48 hours. Follow-up visits ensure proper healing and monitor long-term success.